Sept. 12--For years, U.S. Rep. Andy Barr has campaigned on the promise to repeal and replace the Affordable Care Act, but he doesn't have much to say about that topic these days. After the failure of Republicans to pass their own controversial health care plan, he and other GOP lawmakers facing tough re-election battles have been forced to take a new approach on the campaign trail.

In a TV ad released Monday, Barr revealed his strategy: painting Democratic challenger Amy McGrath as a supporter of a government-run universal health care system.

The plan the ad references is a proposal put forward by U.S. Sen. Bernie Sanders that has gained the support of several major Democrats in Congress. McGrath said she does not support the bill, instead favoring reforms to the Affordable Care Act.

"That [ad] is wrong," McGrath said Tuesday. "I would not cast my vote for that, not that plan as it is currently laid out."

The Barr ad uses McGrath's own words to bolster its claim, but it selectively quotes McGrath talking about a hypothetical situation.

"Amy McGrath is on the record multiple times saying she likes single-payer," said Jodi Whitaker, Barr's spokeswoman. "We take her at her word."

McGrath does support the concept of a single-payer health care system.

"If we were to build a health care system from scratch, single-payer would be the way to go," McGrath says in the ad, which is pulled from a Nov. 8 Facebook Live interview.

The ad does not include the rest of her answer, when she describes her plan to reform the Affordable Care Act, rather than replace it.

"But we have a very complex health care system in America and right now we have the Affordable Care Act, that just came into effect a few years ago," McGrath said. "I believe, as with every major piece of legislation in this country, we should try to make it work."

The ad is an example of a Republican campaign tactic being used in battleground districts throughout the country in an attempt to undercut one of the strongest Democratic campaign talking points.

Health care is a particular vulnerability for Barr, who campaigned for years on repealing Obamacare and then was met with fierce opposition at town halls throughout Central Kentucky's6th Congressional District when he declared his support for a derided Republican health care plan that was eventually abandoned.

McGrath has been careful about her stance on a single-payer system since the beginning of her campaign. In one of the first interviews she did with CNN, she declined to give a yes or no answer on whether she supported single-payer.

In the year since that interview, McGrath has honed her answer. She has repeatedly said she supports a public option for heath care, similar to the insurance plan offered to military veterans. She also has said she supports allowing people over 55 to opt-in to Medicare. Both of those provisions were originally included in the Affordable Care Act.

"I think when you present that to people, people seem to like that because they have an option," McGrath said in an interview with the Herald-Leader in April. "What you don't want to do is you don't want to take people who like their health care and force them to go under a government plan. That's not going to fly in this country, not right now."

At the same time, she's been critical of Barr's stance on health care.

Barr was a firm supporter of the Republican plan to repeal and replace the Affordable Care Act, saying it was an opportunity to enact "the most transformational entitlement reform in American history" by reducing spending on Medicaid. He also said the bill would increase choice and lower health insurance costs.

While the bill passed the House of Representatives with Barr's vote, it was defeated by a group of moderate Republican senators in a dramatic vote on the Senate floor.

Democrats say the GOP bill would have cut access to Medicaid for hundreds of thousands of Kentuckians. Several groups representing doctors and the elderly also opposed the bill, including the American Medical Association and the AARP.